Prevalence of Chronic Rhinosinusitis With Nasal Polyps Higher in Urban Residents, Seniors

In Poland, the prevalence of chronic rhinosinusitis with nasal polyps was shown to be greater in men, elderly individuals, and those living in urban areas.

Greater prevalence of chronic rhinosinusitis with nasal polyps (CRSwNP) in the Polish population was associated with male gender, older age, and living in urban areas, in which inpatient services accounted for a majority of the total cost for the condition. Findings were reported by Advances in Dermatology and Allergology.

Generally affecting middle-aged and elderly patients, the average age at diagnosis of CRSwNP is 40 to 60 years, and male gender and incidence of eosinophilic inflammation have been cited as risk factors.

Compared with patients who have CRS without nasal polyps, those who have CRSwNP have been linked with more severe disease and a greater comorbidity burden that requires long-term continuous pharmacotherapy and regular consultations with specialists or surgery.

“The typical features associated with CRSwNP are chronicity, a tendency to recur, and a frequent need for glucocorticoid and surgical treatment, generating considerable direct and indirect socioeconomic costs,” added the study authors. “Generally, once diagnosed, CRSwNP is a lifelong health problem in most cases.”

They conducted a ​​statistical analysis of data on reported prevalence of CRSwNP in the Polish population, including demographics and comorbidities, as well as costs of outpatient and inpatient services financed by the National Health Fund (NHF) registers from 2008 to 2018.

Of the 33,876,567 people assessed for the study, the number of patients receiving outpatient or hospital services related to CRSwNP ranged from 29,900 to 32,500 annually. In 2018, 28,200 patients attended 58,200 ambulatory visits for CRSwNP (2.06 per patient) and 4400 patients had 4700 hospital admissions (1.06 per patient).

Per 10,000 Polish population, the recorded prevalence of CRSwNP in 2018 was 52.0 (52%), with men exhibiting greater prevalence vs women (64.6/10,000 [0.65%] vs 40.2/10,000 [0.40%]). Prevalence was also shown to vary by geographic location, with both men and women reporting greater incidence if they lived in urban vs rural areas (men: 75.3/10,000 vs 49.1/10,000; women: 46.3/10,000 vs 30.7/10,000).

Moreover, CRSwNP was more frequent in patients aged 55 to 59 years (98.1/10000) and 75 to 79 years (98.7/10,000). Among men, the highest prevalence was among those aged 75 to 79 years (164.3/10,000), and in women, prevalence peaked in the 55-to-59 age group (75.1/10,000).

Regarding cost, the Polish NHF spent 17.2 million zł in 2018 (equivalent to US $4.7 million) on health services related to the diagnosis of nasal polyps, with inpatient services accounting for 77.4% of the total cost. The highest level of costs per patient was exhibited in regions where the highest share of hospital services was also observed.

“The NHF data in comparison with a population-wide epidemiological study show that a large proportion of patients with nasal polyps do not receive regular treatment or even do not seek medical attention,” concluded the study authors. “The treatment of patients with nasal polyps is not cost effective.”

Reference

Raciborski F, Arcimowicz M, Samoliński B, et al. Recorded prevalence of nasal polyps increases with age. Postepy Dermatol Alergol. 2021 Aug;38(4):682-688. doi:10.5114/ada.2020.99365